The anesthesia specialty has enjoyed great success in recent decades in reducing its incidence of medically induced injury, which has led to some talk about how supposedly other branches of medicine should just go and do likewise instead of griping about the rate at which they are sued. But as Medical Economics (via KevinMD) finds, it's not that simple.

Incidentally, because anesthesiologists are now more vigilant than ever not to court an overdose risk by giving patients any more than the minimum they need, there is apparently a rising incidence of the phenomenon of "anesthesia awareness", in which underdosed patients are actually aware of the surgery in progress and perhaps end up undergoing psychological trauma as a result. So what happens next? You guessed it.

More: anesthesiologist Clark Venable, at Waking Up Costs, says I'm mistaken on two counts in the paragraph just ended. First, he says, "Overdose risk is not and was never a cause of patient morbidity and mortality in my field." (In the Law.com clip linked above, a former president of the anesthesiology society refers to "the need to give the patient only as much anesthesia as his or her body can tolerate". Possibly I was too hasty in resorting to the word "overdose" to capture this aspect of the safety picture, but a search on "anesthesia overdose malpractice" confirms that I had plenty of company in thinking that anesthesia overdose has sometimes been a cause of injury to surgical patients. Venable also disputes that the underlying rate of "anesthesia awareness" in surgery is in fact on the rise, saying the real explanation may be that more attention is being paid to a problem already present. And: in another post, Dr. Venable clarifies things further, and writes: "The point I tried to make (though not well) was that overdose is not something we presently worry about and does not explain the apparent increase in awareness under anesthesia."